Shannon Jaylene, Peters Kath, Blythe Stacy
Generalist Community Nursing, Mid North Coast Local Health District, Wauchope 2446, Australia.
School of Nursing and Midwifery, Western Sydney University, Penrith 2750, Australia.
Children (Basel). 2021 Feb 22;8(2):167. doi: 10.3390/children8020167.
The postnatal period is crucial for infants in establishing a connection with and security in primary caregivers and can have enduring effects on attachment patterns. However, due to the need for symptom management, many infants diagnosed with neonatal abstinence syndrome (NAS) may be separated from primary caregivers and cared for in a neonatal intensive care unit (NICU) or special care nursery (SCN) soon after birth. Research has shown that substance-exposed infants are more likely to experience insecure attachment patterns with their primary caregivers and that mothers with a history of substance abuse are less sensitive to their infants' cues. Therefore, the aim of this research was to explore nurses' and midwives' experiences in promoting the attachment relationship for infants admitted to an NICU/SCN with NAS. A qualitative research design was used to gather data on the experiences of nine nurses/midwives from various NICU and SCN settings in Australia. Individual, semi-structured interviews were conducted, and transcribed interviews were coded using thematic analysis. While nurses/midwives valued the attachment relationship for infants with NAS, facilitation of the attachment relationship was mainly promoted when the mother was present. However, parents were often reported to be absent from the nursery. Difficulties in promoting an attachment relationship were also identified when an infant had child protection involvement. This research identifies areas in need of innovative change regarding the approach taken to promote the attachment relationship for infants with NAS when they are admitted to an NICU/SCN.
产后时期对于婴儿与主要照顾者建立联系并获得安全感至关重要，且可能对依恋模式产生持久影响。然而，由于需要进行症状管理，许多被诊断为新生儿戒断综合征（NAS）的婴儿可能在出生后不久就与主要照顾者分离，在新生儿重症监护病房（NICU）或特殊护理病房（SCN）接受护理。研究表明，接触过药物的婴儿更有可能与主要照顾者形成不安全的依恋模式，且有药物滥用史的母亲对婴儿的暗示反应较不敏感。因此，本研究的目的是探讨护士和助产士在促进入住NICU/SCN且患有NAS的婴儿的依恋关系方面的经验。采用定性研究设计来收集来自澳大利亚不同NICU和SCN机构的九名护士/助产士的经验数据。进行了个体半结构化访谈，并对访谈记录进行主题分析编码。虽然护士/助产士重视患有NAS的婴儿的依恋关系，但依恋关系的促进主要在母亲在场时进行。然而，据报告父母经常不在病房。当婴儿涉及儿童保护问题时，也发现了促进依恋关系的困难。本研究确定了在入住NICU/SCN的患有NAS的婴儿促进依恋关系的方法方面需要创新变革的领域。
